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2014012-XXX Resp Illness UC_CA

ICR 201410-0920-034 · OMB 0920-1011 · Object 51243701.

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Form Approved

OMB No. 0920-1011

Exp. Date 03/31/2017















Interview Form
































Public reporting burden of this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74 Atlanta, Georgia 30333; ATTN: PRA (0920-1011)






























Prospective Pneumonia Surveillance Form

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title 2014012-XXX Resp Illness UC_CA
AuthorCDC User
File Modified0000-00-00
File Created2021-01-26